Parathyroids
Parathyroid Hormone: PTH
 
Primary Hyperparathyroidism <ul><li>Elevated Blood Calcium Level Î Ca </li></ul><ul><li>Elevated Parathyroid Hormone Level...
Symptoms Hyperparathyroidism Population: Women 40-75 Stones Bones Abdominal Groans
Osteoporosis
Osteoporosis Tibia Bone Loss
Primary Hyperparathyroidism <ul><li>Serum Calcium (ionized) Î </li></ul><ul><li>Serum PTH Î  </li></ul><ul><li>Excessive C...
Parathyroid Adenoma Benign Tumor of PT Gland
Parathyroid Scan
Parathyroid Scan
Parathyroid Ultrasound
Neck Exploration
Parathyroid Adenoma
Mini-Incision Parathyroidectomy
Lateral Approach to Parathyroids
Benefits of Preoperative Localization <ul><li>Smaller Incision </li></ul><ul><li>Shorter Operative Time </li></ul><ul><li>...
Aberrant Locations and Multiple Adenomas <ul><li>Aberrant Location: 5-10% </li></ul><ul><li>Multiple Adenomas: 10-20% </li...
Surgical Preparation <ul><li>IOPTH </li></ul><ul><li>Gamma Counter </li></ul><ul><li>Nerve Dissector </li></ul>Equipment
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Hyperparathyroidism Presentation

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Hyperparathyroidism Presentation

  1. 1. Parathyroids
  2. 2. Parathyroid Hormone: PTH
  3. 4. Primary Hyperparathyroidism <ul><li>Elevated Blood Calcium Level Î Ca </li></ul><ul><li>Elevated Parathyroid Hormone Level Î PTH </li></ul><ul><li>Excessive Calcium in Urine </li></ul><ul><li>Thinning of Bones: Dexa Scan </li></ul>Cause: Parathyroid Adenoma
  4. 5. Symptoms Hyperparathyroidism Population: Women 40-75 Stones Bones Abdominal Groans
  5. 6. Osteoporosis
  6. 7. Osteoporosis Tibia Bone Loss
  7. 8. Primary Hyperparathyroidism <ul><li>Serum Calcium (ionized) Î </li></ul><ul><li>Serum PTH Î </li></ul><ul><li>Excessive Calcium in Urine </li></ul><ul><li>Thinning of Bones </li></ul>Diagnosis and Tests
  8. 9. Parathyroid Adenoma Benign Tumor of PT Gland
  9. 10. Parathyroid Scan
  10. 11. Parathyroid Scan
  11. 12. Parathyroid Ultrasound
  12. 13. Neck Exploration
  13. 14. Parathyroid Adenoma
  14. 15. Mini-Incision Parathyroidectomy
  15. 16. Lateral Approach to Parathyroids
  16. 17. Benefits of Preoperative Localization <ul><li>Smaller Incision </li></ul><ul><li>Shorter Operative Time </li></ul><ul><li>Different Anesthesia Options </li></ul><ul><li>Ambulatory vs. Overnight </li></ul><ul><li>Decrease Rate of Missed or Multiple Adenomas </li></ul>Controlled Surgical Environment
  17. 18. Aberrant Locations and Multiple Adenomas <ul><li>Aberrant Location: 5-10% </li></ul><ul><li>Multiple Adenomas: 10-20% </li></ul>
  18. 19. Surgical Preparation <ul><li>IOPTH </li></ul><ul><li>Gamma Counter </li></ul><ul><li>Nerve Dissector </li></ul>Equipment
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